Atlanto-occipital dissociation

Presentation

Patient Data

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Lateral

Trauma room horizontal beam x-ray showing marked non-survivable atlanto-occipital dissociation with several centimetres of seperation between the lateral masses of C1 and the occipital condyles. Marked prevertebral soft-tissue thickening is also seen displacing the ETT anteriorly.

Case Discussion

The cervical spine radiograph has little roll in the imaging of the cervical spine in adult major trauma as CT is the investigation of choice, however clinical suspicion of non-survivable atlanto-occipital dissociation in this case promoted the trauma team to perform an x-ray in the trauma bay. By quickly confirming a non-survivable injury, a superfluous trauma CT pan scan was able to be avoided.